Health experts warn that Thailand is vulnerable to a second wave of COVID-19 infections due to neglect of the country’s massive migrant labor sector. Migrant workers often live in squalid, cramped conditions without adequate sanitation and poor access to medical care.
Thai media has fanned anti-migrant prejudice creating a “us” (Thai citizens) versus “them” mentality. But Dr. Vit Suwanvanichkij, an epidemiologist with long experience of assisting migrant communities, warned that “COVID-19 does not distinguish between Thais and non-Thais. An outbreak in any of these crowded migrant settlements affects all of us; there is no such thing as ‘us’ or ‘them.’ From a COVID-19 standpoint, these are the proverbial ticking time bombs.”
The 3.9 million migrants in Thailand — approximately 10 percent of the total workforce — have been hit hardest by mass lay-offs of workers since the COVID-19 outbreak. Johnny Adhikari runs a migrant charity called Metta in the Thai -Myanmar border town of Mae Sot. He told The Diplomat that “90 percent of all Myanmar migrants have lost their jobs, leaving over 750,00 people stranded in Thailand since the borders were closed without any income. Many are desperate for food and shelter.”
Three Thailand-Myanmar border checkpoints have been partially reopened since May 19 to permit migrants to get back home. But with Myanmar ill-prepared to provide sufficient quarantine facilities for returnees, only 50,000 have been accepted for repatriation so far at the Mae Sot immigration checkpoint.
Many fear that Thailand is highly vulnerable to the kind of second wave of COVID-19 infections that caught Singapore by surprise. In early April, Singapore was being hailed as one of the countries that had got its coronavirus response right. It appeared that the city-state seemed to have suppressed cases without imposing the restrictive lockdown measures endured by millions elsewhere.
But the authorities sadly neglected to include the migrant labor dormitories in their COVID-19 prevention management plan.
Tommy Koh, Singapore’s former foreign minister, wrote on Facebook: “The dormitories were like a time bomb waiting to explode. The way Singapore treats its foreign workers is not First World, but Third World.”
As a result of this oversight, more than 20,000 of Singapore’s migrant workers caused an unexpected “second wave” of confirmed cases, with the city-state regularly reporting over 1,000 new cases a day at one point. The country now has over 34,800 confirmed cases after having a total of exactly 1,000 cases on April 1.
Adisorn Kerdmongkul, the manager of the Migrants Working Group (MWG), is worried that Thailand’s neglect of the plight of 700,000 vulnerable migrants could also bring about a dramatic surge in infections, as happened in Singapore. “They are not able to take care of themselves financially and their health suffers,” Adisorn added. “At the same time, without thorough testing and medical checks, it is feared that many poor people may be infected.”
The problem of the migrant health in Thailand was summed up by Brahm Press, the director of migrant support agency MAP Foundation in Chiang Mai: “Migrants are always the last to be considered in health care. and the last to receive PPE protective aids.”
At Thailand’s Ministry of Health, Dr. Supakit Sirilak, the deputy permanent secretary, told The Diplomat the authorities “are aware of the threat of a second wave, but we think Thai situation is less vulnerable than Singapore.”
“We have alerted all provinces to mount health checks on migrant communities,” Supakit continued. “We have done saliva testing for COVID-19 on 6,000 migrants in the provinces and they all turned out negative.”
However migrant organizations are not convinced there has been enough Thai government support. Migrant adviser Adisorn reported after the economic shutdowns, “We found that around 500,000 migrants had not received health insurance renewals due to their loss of work permits and around 1,000,000 migrant workers were without social security.”
But that would not stop migrants from getting hospital treatment, according to the government. Dr. Supakit claimed that “if migrants have no health insurance and no money to pay for it, then the hospital has to provide free treatment.” However, Adisorn disputed this claim, saying, “Migrants are too afraid to visit a hospital without any money. because many hospitals will not accept them.”
This is why the migrant NGOs like the Mekong Migration Network and other humanitarian agencies have appealed to the Thai government to declare “a clear policy of access to free public healthcare appropriately prepared to deal with the complexities of a pandemic.”
That a major outbreak of COVID-19 infection among migrants has not already occurred in Thailand can largely be attributed to the dedicated work of the Migrant Health Volunteers (MHVs) network, which reaches out to the migrant communities.
Migrant workers make up a large share of people in provinces like Ranong and Samut Sakhon in central Thailand where certain pockets are known as “Little Myanmar.” Viroonsiri Arayawong, a researcher of the Department of Health Service Support, told the Bangkok Post that “MHVs and the VHV [Thai Volunteer Health Workers] form the backbone of manpower controlling the spread of diseases in migrant worker communities.”
MHVs are usually from the same nationalities as the migrant workers, and act as interpreters for Thai officials passing on information about COVID-19 infections. The Health Ministry’s Dr. Supakit also cited the Migrant Health Volunteers as very important, saying, “We have provided medical training to the volunteers with 500 operating in Samut Prakhon alone. They are effective in five provinces.”
But what will happen in the capital, Bangkok, with a large migrant worker population not covered by the volunteer scheme? The health ministry admits that Bangkok, where at least 16 migrants have already tested positive, is a major concern.
The health ministry concedes that they need more funds to help migrants, but Dr. Supakit noted “we cannot use the special Thai budget for unemployed workers” for that purpose. The budget only covers Thai workers, “and the cabinet says it cannot be extended to cover migrant workers.”
At the same time, the ministry admits that with migrants living in dormitories, sometimes with eight people in one room, social distancing is impossible, and their accommodation especially in the capital, needs to be improved.
Is the Thai government doing enough to avert another Singapore-style disaster? Dr. Vit Suwanvanichkij predicts that “the cramped and squalid migrant living conditions that give rise to these heightened vulnerabilities will continue to pose omnipresent threats to Thailand’s prospects of being able to sustain successful control initiatives in the country.”
But the COVID-19 emergency also provides an opportunity for Thailand to reflect on the importance of migrants to the Thai economy, and to take better care of their welfare and rights in accordance with International Labor Organization conventions.
The strong message from migrant aid groups and UN agencies is that protecting the rights of migrants will also benefit Thai citizens, by taking all necessary precautions to avert a second wave of infections.
Tom Fawthrop is an author, journalist and film-maker covering the Mekong region since the 1980s.